Insuring Home Care, Hospice & Medical Staffing Firms

One Program, One Solution, One Call

Contact Us for A Quote

Manchester Specialty Programs, Inc.

The Recovery Audit Contractor (RAC) program was established by Congress to identify and recover overpayments in Medicare and Medicaid. Third-party contractors conduct billing audits and are paid on a contingency fee basis for overpayments found. These audits have the potential to open up a healthcare agency or facility to exposures involving many types of violations.

The government has also hired Zone Program Integrity Contractors (ZPICs) to investigate fraud and abuse for all Medicare-related claims. This includes audits on providers and suppliers of Part A, Part B, Part C, the Medicare prescription drug benefit (Part D), durable medical equipment, prosthetics, and orthotics supplier (DMEPOS), home health and hospice, and Medicaid services. If a provider is selected for a ZPIC audit, the firm is either the subject of a fraud investigation or the contractor is reviewing claims information to determine whether an investigation should be open.

Coverage Available for RAC, ZPIC, MIC and MAC Audits

To address the potential exposures that come with these audits, Manchester Specialty Programs offers very specific health care fraud and abuse insurance coverage for hospice, home health care agencies, VNAs and DMEs. The coverage is offered as part of our Directors’ and Officers’ (D&O) liability coverage, and is designed to respond to alleged violations of the False Claims Act and other health care fraud and abuse matters, including Recovery Audit Contractor (RAC), ZPIC, MIC and MAC audits, brought by or on behalf of the government. Our healthcare fraud and abuse component provides:

Coverage includes defense, audit fines and penalties

An early claims trigger for notice of investigation, subpoena or search warrant (as opposed to any particular kind of audit) – we can step in and help to mitigate losses from the very beginning of the process

Coverage options for health care fraud and abuse fines and penalties, subject to insurability under the law

Along with this insurance coverage, information is available from our partner carrier to help insureds remain in compliance and be prepared in the event of an audit. In fact, our carrier was the first to bring regulatory audit coverage to the health care market over 20 years ago, bringing your insureds unmatched experience in the regulatory audit response and management of the appeal process.

*Please note that this information is provided as a general overview only for agents, brokers and health care businesses. Actual coverage may vary and is subject to the actual policy language as issued. Eligibility and pricing is based on each individual risk.

JOIN OUR MAILING LIST

Your Email:

Contact us, or have your own local insurance broker call us.

To find out more about our specialty insurance programs, please give us a call at 855-972-9399 or simply complete and submit the form on this page. We work exclusively with local and national independent insurance brokers. If you already have a broker, we would be happy to speak with them. (A key advantage to our program is that you can work with us through your own local insurance representative.) If a broker or agent doesn’t currently represent you, we’ll put you in touch with an insurance representative in your area.